华南地区年轻乳腺癌患者的临床特征及预后因素分析  

Clinical characteristics and prognosis of very young patients with breast cancer in the southern of China

作　　者：杨桦[1,2] 王思愚[1,2] 区伟[1,2] 孙海波[1,2] 方勤[1,2] 

机构地区：[1]华南肿瘤学国家重点实验室,广东广州510060 [2]中山大学肿瘤防治中心胸科,广东广州510060

出　　处：《癌症》2009年第12期1310-1316,共7页Chinese Journal of Cancer

摘　　要：背景与目的:西方国家年轻乳腺癌发病率较低,年龄<35岁是影响乳腺癌预后的因素之一。本研究比较华南地区年轻乳腺癌(年龄<35岁)和非年轻绝经前(年龄≥35岁)患者的临床病理特征和预后,初步探讨影响年轻乳腺癌的预后因素。方法:收集2003年10月至2006年12月中山大学肿瘤防治中心收治的905例绝经前可手术乳腺癌患者的临床资料,其中年龄<35岁的年轻患者189例(研究组),≥35岁者716例(对照组),回顾性分析年轻乳腺癌患者的临床病理特征及复发情况。结果:全组患者中位随访时间为27.77个月。研究组3年无病生存率(disease-free survival,DFS)为78.0%,对照组3年DFS为89.1%,两组间差异有统计学意义(P<0.001)。研究组3年总生存(overall survival,OS)率为94.3%,对照组3年OS率为96.8%,两组间差异无统计学意义(P=0.10)。研究组和对照组ER或PR阴性患者的DFS与OS差异无统计学意义(P>0.05);研究组中ER或PR阳性患者的DFS与OS均差于对照组(P<0.05)。单因素分析和多因素分析表明,年龄<35岁、淋巴结转移、脉管癌栓以及Ki67高表达均为复发高危因素。结论:<35岁的HR阳性者年轻乳腺癌患者预后较≥35岁绝经前患者差。Background and Objective. Even though most breast cancers occur in postmenopausal women in western countries, age 〈35 is one of the prognostic factors. This study was to compare the clinicopathologic characteristics and prognosis between premenopausal breast cancer patients aged of 〈35 and ≥35 in south China, and to explore the prognostic factors. Methods. A total of 905 consecutive premenopausal patients were evaluated, with first diagnosis of breast cancer referred to surgery at the Sun Yat-sen University Cancer Center from October 2003 to December 2006. The clinicopathologic factors and the survival rates between the very young group （aged of 〈35 at diagnosis） and the non-young group （aged of ≥35 at diagnosis） were retrospectively compared. Results： The overall median follow-up time was 27.77 months. The 3-year disease-free survival rate was significantly lower （78.0% vs. 89.1%, P〈0.001） and the 3-year survival rate relatively lower（94.3% vs. 96.8%, P=0.10） in the very young group than in the non-young group. In addition, the 3-year survival and disease-free survival rates were significantly lower in the very young group with HR （hormone receptor）-positive than in the non-young group （P〈0.05）. The univariate and multivariate analysis of clinicopathologic characteristics between two groups showed that age 〈35 at diagnosis, axillary lymph node involvement, presence of vascular invasion, and high expression of Ki67 were risk factors for recurrence. Conclusion： Compared with non-young premenopausal patients, very young breast patients with HR-positive cancer have a worse outcome.

关 键 词：乳腺肿瘤 临床特征 预后因素 年轻 

分 类 号：R737.9[医药卫生—肿瘤]